1. Field of the Invention
The present invention relates generally to methods and surgical procedures for treating sleep-disordered breathing, and particularly to an endoscopic nasal palatoplasty procedure using an instrument inserted endonasally to perform procedures on the soft palate and/or uvula.
2. Description of the Related Art
Various breathing problems are well known to result in corresponding difficulties in sleep, including snoring, sleep apnea, restless sleep and corresponding daytime somnolence. These various problems are not only difficult for the subject, but for the sleeping partner of the subject as well. Reduced oxygenation due to breathing interruption during more severe episodes is particularly problematic, and extreme cases have been known to result in hypertension, cardiac arrhythmia, and even death due to breathing cessation during apnea.
The physical causes of the above problems are reasonably well understood, ranging from nasal turbinate hypertrophy to lingual and maxillary displacement to a narrowing of the pharynx due to partial obstruction by the soft palate and/or uvula. The latter syndrome is particularly likely when the soft palate and/or uvula are more flaccid than normal. Oral breathing to overcome this, particularly during sleep, tends to result in inferior and/or posterior displacement of the mandible and the base of the tongue, thereby exacerbating the problem.
Accordingly, a number of treatments have been developed over the years. Generally, less invasive treatments are attempted initially, e.g., continuous positive airway pressure (CPAP). However, when such treatment is ineffective, surgical treatment is often called for. Such surgical treatment may comprise one or more of a large number of different procedures, including septoplasty, turbinoplasty, tonsillectomy and/or adenoidectomy, uvulopalatopharyngoplasty, and/or possibly other procedures.
One such procedure comprises modification of the soft palate and/or uvula to stiffen these organs and to reduce their posterior displacement. This has been conventionally accomplished in the past by means of the placement of small implants in the soft palate, or by cauterizing or ablating the soft palate and/or uvula tissue to produce scarring of those tissues and to reduce their flaccidity. This may also result in some reduction in the size and/or posterior extension of these organs. These surgical procedures have been accomplished conventionally by accessing the inferior surface(s) of the soft palate and/or uvula through the mouth of the patient. The problem with accessing these structures orally is that the treatment is applied to the inferior surfaces of the organs, thus tending in many cases to draw the soft palate and/or uvula downward. This oral access technique may also result in some destruction of the oral mucosa, which is not desirable.
Thus, an endoscopic nasal palatoplasty procedure solving the aforementioned problems is desired.